There is a saying“if I had a pound for every time I was asked …” This is one question that many patients ask at some point during their course of treatment, and I look forward to referring them to our blog for answers from now on!
I will try to answer this without bias but please note that I am an osteopath and therefore cannot be truly objective. It is worth noting that as an aspiring health practitioner, I did consider all three, but chose osteopathy from some specific reasons that are still valid in my eyes today.
Osteopathy
is a holistic form of manual therapy, which deals with a wide range of acute, chronic and systemic disorders of the body, both musculoskeletal and visceral.
Osteopathy uses in-depth physiological and clinical knowledge, coupled with keen observation and palpatory skills. The osteopath will combine a detailed health case history with a thorough physical evaluation to diagnose the patient’s condition and treat it. The patient’s diet, work and leisure practices all inform this process.
The osteopath doesn’t treat a painful back, stomach or knee, but a body as a whole unit that is suffering an injury, and must be treated in an integrated manner to return to good balance and function: can an injured knee be treated conclusively without addressing the biomechanics of the ankle, hip, pelvis and back? The osteopath’s aim is not merely symptomatic relief, but addressing the underlying causes of the current presentation to prevent any re-occurrence.
Osteopathic treatment combines joint mobilisation – and occasionally manipulation – with work on muscles and ligament tension, as well as gentle work on visceral structures when required.
As naturopathic osteopaths, our specific bias is not merely to achieve better functional alignment of our patients’ bodies, but also to impart dietary, exercise and lifestyle advice that more generally enhance their long-term health.
More about what is ‘holistic’ osteopathy and a description of osteopathy here.
Chiropractic
The origins of Chiropractic are close to osteopathy, as the first chiropractor was a student of the founder of osteopathy. Indeed, in some instances, one would be hard-pressed to distinguish between the treatment provided by a good chiropractor and osteopath. However, a large proportion of chiropractors focus treatment on manipulation of spinal segments to normalise spinal position and effect underlying nerve roots.
Treatment plans are often based on regular manipulation for a set number of sessions in order to wholly correct a disorder. Chiropractors also often use imaging to aid diagnosis such as x-ray. These x-rays will often be conducted in the clinic as part of the course of treatment.
Physiotherapy
is the most commonly known form of ‘manual therapy’ due to its prevalence within the NHS.
Physiotherapists specialise in the rehabilitation of acute and chronic joint injury, often using a variety of prescribed exercises that the patient carries out when away from the treatment couch. Physios also use machines such as ultrasound or TENS machines to facilitate change in an injured area.
NHS Physiotherapists tend not to have diagnostic input, the diagnosis and treatment request tending to emanate from an orthopaedic surgeon, consultant rheumatologist etc. As a result, treatment will also tend to be more specific than integrative.
Inevitably, this brief snapshot doesn’t do justice to the development of three different forms of manual therapy with their unique methods and philosophy. It merely attempts to highlight some of the key differences in clinical practice that you can expect from each – although as suggested above, the practice of some physios and chiropractors is sufficiently all encompassing as to be well aligned with osteopathic practice.
Sadly too, some osteopaths also stray into being too specific in their form of treatment, and come to rely too heavily on joint manipulation.
The information on this website should not be used as a basis for diagnosis, choice of treatment or choice of medical practitioner.
I would completely disagree with the statement that ‘NHS Physiotherapists tend not to have diagnostic input’. Yes I accept that in an out patient clinic within the NHS they will receive referrals from consultants determining diagnoses and dictating protocols, but the majority of patients seen will be from General Practitioners who do not provide diagnoses. Physiotherapists are autonomous and will make their own diagnosis and treatment plan as a result.
I totally agree with Graham. Physiotherapists have a huge role to play in diagnostics and in some instances work entirely in a diagnostic role especially those that work as extended scope practitioners. All physiotherapists will assess and diagnose regardless of where the initial referral came from. It is worth asking why chiropractors and osteopaths choose to work outside the NHS when it is the richest source of patients and educaton.